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Abstract:

Various arthroscopic shavers are provided that minimize contact between
bodily fluid and the shaver hand piece. Arthroscopic shavers generally
include a cutting assembly mated to a hand piece. In one embodiment, the
shaver includes a hub that connects the cutting assembly with the hand
piece and has an exit port configured to transport cut tissue and fluid
from the device. In another embodiment, the shaver includes a hub
configured to retrofit existing shaver hand pieces having interior lumens
for removing cut tissue and fluid. The hub further includes an exit port
that diverts fluid away from the hand piece.

Claims:

1. A tissue cutting assembly, comprising: an outer shaft having an outer
cutting tip formed on a distal end thereof; an inner shaft rotatably
disposed within the outer shaft and configured to couple to a driver, the
inner shaft having an inner tissue cutting tip formed on a distal end
thereof; and a hub coupled to the inner shaft and the outer shaft and
configured to releasably mate with a handle assembly having a driver
disposed therein, the hub being configured to prevent fluid from coming
into contact with a handle assembly when the hub is coupled to a handle
assembly; wherein tissue cut by the outer and inner tissue cutting tips
is configured to flow through the inner shaft.

2. The tissue cutting assembly of claim 1, further comprising an exit
port configured to allow fluid and tissue to pass therethrough and being
positioned to prevent fluid and tissue from flowing out through a
proximal end of the cutting assembly.

3. The tissue cutting assembly of claim 1, wherein the hub includes a
driver mating feature for releasably coupling to a driver disposed in a
handle assembly.

4. The tissue cutting assembly of claim 1, wherein the hub includes a
handle mating feature for releasably coupling to a handle assembly.

5. The tissue cutting assembly of claim 1, wherein the inner shaft
includes at least one port configured to allow fluid and tissue to pass
therethrough.

6. The tissue cutting assembly of claim 3, wherein the exit port is
positioned distal of the driver mating feature formed on a proximal end
of the hub.

7. The tissue cutting assembly of claim 2, wherein the exit port has a
central axis that extends transverse to a central axis of the inner and
outer shafts.

8. The tissue cutting assembly of claim 1, wherein a distal end of the
hub is mated to a proximal end of the inner shaft.

9. The tissue cutting assembly of claim 3, wherein the hub is configured
to mate with a driver such that the driver is effective to rotate the
inner shaft relative to the outer shaft.

10. An arthroscopic tissue shaver device, comprising: a handle having a
driver disposed therein; a shaft assembly having an outer shaft and an
inner shaft, the inner shaft being rotatably disposed within the outer
shaft, the inner and outer shafts having at least one opening formed in
distal ends thereof, and the inner shaft having a tissue cutting distal
tip positioned adjacent to the at least one opening in the outer shaft
for cutting tissue exposed through the opening; and a coupler operably
connected between the handle and the shaft assembly for transferring a
drive force from the driver to the inner shaft, the coupler having an
exit port formed therein for receiving fluid from an inner lumen of the
inner shaft, and the coupler being configured to prevent passage of the
fluid from the inner lumen of the inner shaft to the handle.

11. The device of claim 10, wherein the coupler includes a proximal end
mated to the driver in the handle, and a distal end mated to a proximal
end of the inner shaft such that actuation of the driver is effective to
rotate the inner shaft.

12. The device of claim 10, wherein the coupler is removably connected to
the handle and to the shaft assembly.

13. The device of claim 10, wherein the shaft assembly is configured to
press-fit with the coupler.

14. The device of claim 10, wherein the shaft assembly and the coupler
are integrally formed.

15. The device of claim 10, wherein the coupler has an inner lumen formed
therein and having a first end in communication with the inner lumen of
the inner shaft, and a second end in communication with the exit port.

16. The device of claim 15, wherein the inner lumen of the coupler
terminates at a location distal of a proximal end of the coupler.

17. A connector for use with a tissue shaver, the connector comprising: a
housing having proximal and distal ends, the proximal end having a drive
feature for coupling to a driver disposed in a handle of the tissue
shaver, and the distal end having a drive feature for coupling to a
corresponding drive feature on a proximal end of an inner shaft of a
tissue shaver, the housing further having a lumen formed therein and
extending between an entry port formed in the distal end of the housing
for receiving fluid from an inner shaft of a tissue shaver, and an exit
port formed in a sidewall of the housing at a location distal to the
proximal end of the housing for directing fluid away from a handle of a
tissue shaver.

18. The connector of claim 17, wherein the proximal end of the housing
has a first mating feature formed thereon and configured to press-fit
with a handle of a tissue shaver, and the distal end of the housing has a
second mating featured formed thereon and is configured to press-fit with
a shaft assembly of a tissue shaver.

19. The connector of claim 17, wherein the proximal end of the housing is
sealed to prevent tissue and fluid flowing through the lumen in the
housing from contacting a handle of a tissue shaver mated to the housing.

20. The connector of claim 17, wherein the lumen is substantially
L-shaped.

Description:

FIELD

[0001] The present invention relates to endoscopic shavers for cutting and
removing tissue from the body and methods of using the same.

BACKGROUND

[0002] Arthroscopy is a minimally invasive technique for removing diseased
or damaged tissue from intra-articular regions of the body, such as the
shoulder, hip, wrist, knee, and spine. Arthroscopic shavers can be used
to remove bone, cartilage, and other soft tissue from a patient's joint
with less surgical trauma to the joint than conventional surgical
techniques. Typically, an arthroscopic shaver is an electro-mechanical
device that includes a hand piece and a cutting assembly. The cutting
assembly often has an elongate, rotatable member for cutting tissue and
removing tissue and fluid from a surgical site. The shaver hand piece
usually has an integrated aspiration/suction port for transferring tissue
and fluid through the hand piece and to a waste collection container. The
hand piece can be releasably mated to the cutting assembly so that the
cutting assembly can be disposed of after each use.

[0003] During an arthroscopic procedure, the cutting assembly of the
shaver is inserted into a small incision. Suction is applied to a suction
port that extends through the handle, causing bodily tissue and
associated fluids to flow through the cutting assembly and out through a
proximal end of the hand piece. After the procedure is completed, the
shaver blade is typically disposed of while the hand piece is sent to a
processing center for cleaning and sterilization. Because fluid and
tissue can become lodged inside of the hand piece, the hand piece must be
thoroughly cleaned after each use through an aggressive series of
brushing operations and/or using automated washing machines. Although the
brushing is necessary to remove biological material from the hand piece,
it can decrease the durability of the mechanical components and damage
the seals within the shaver hand piece. There is also evidence that these
conventional cleaning techniques are ineffective at removing biological
material. The United States Food and Drug Administration has investigated
the cleaning of the shaver hand pieces and found numerous cases where
tissue has remained in the shavers after cleaning, compromising the
sterility of a surgical site.

[0004] Accordingly, there remains a need for a tissue shaver that is
easier to clean and that has a decreased risk of contaminating a surgical
site.

SUMMARY

[0005] The present invention provides various embodiments of arthroscopic
shavers. In one embodiment, a cutting assembly for use with a shaver hand
piece is provided that includes an outer shaft having an outer cutting
tip formed on a distal end thereof and an inner shaft rotatably disposed
within the outer shaft and configured to coupled to a driver. The inner
shaft can include an inner tissue cutting tip formed on its distal end.
The cutting assembly can further include a hub coupled to the inner and
outer shafts and configured to releasably mate with a handle assembly
having a driver disposed therein. The hub can also be configured to
prevent fluid from coming into contact with a handle assembly when the
hub is coupled to a handle assembly. Thus, tissue cut by the outer and
inner cutting tips can flow through the inner shaft without ever
contacting the handle assembly.

[0006] The cutting assembly can have a variety of features. For example,
the cutting assembly can further include an exit port configured to allow
fluid and tissue to pass therethrough and being positioned to prevent
fluid and tissue from flowing out through a proximal end of the cutting
assembly. The hub can further include a driver mating feature for
releasably coupling to a driver disposed in a handle assembly, and a
handle mating feature for releasably coupling to a handle assembly. In
certain aspects, the inner shaft can include at least one port configured
to allow fluid and tissue to pass therethrough. The exit port of the
cutting assembly can also be positioned distal of the driver mating
feature formed on a proximal end of the inner hub, and can have a central
axis that extends transverse to a central axis of the inner and outer
shafts. The distal end of the hub can be mated to a proximal end of the
inner shaft. The hub can also be configured to mate to a driver such that
the driver is effective to rotate the inner shaft relative to the outer
shaft.

[0007] In another embodiment, an arthroscopic tissue shaver can include a
handle having a driver, a shaft assembly, and a coupler operably
connected between the handle and the shaft assembly. The shaft assembly
can include an outer shaft and an inner shaft having at least one opening
formed in their respective distal ends and the inner shaft being
rotatably disposed within the outer shaft. The inner shaft can further
include a tissue cutting distal tip positioned adjacent to the at least
one opening in the outer shaft for cutting tissue exposed through the
opening. The coupler can operably connect the handle and the shaft
assembly and it can transfer a drive force from the driver to the inner
shaft. The coupler can also include an exit port for receiving fluid from
an inner lumen of the inner shaft and it can be configured to prevent
passage of the fluid from the inner lumen of the inner shaft to the
handle.

[0008] The arthroscopic tissue shaver can have various configurations. For
example, in one embodiment the coupler includes a proximal end mated to
the driver in the handle, and a distal end mated to a proximal end of the
inner shaft such that actuation of the driver is effective to rotate the
inner shaft. The coupler can also be removably connected to the handle
and to the shaft assembly. In another embodiment, the shaft assembly and
the coupler are integrally formed. The coupler can also have an inner
lumen formed therein, a first end in communication with the inner lumen
of the inner shaft, and a second end in communication with the exit port.
In one embodiment, the inner lumen of the coupler can terminate at a
location distal of a proximal end of the coupler.

[0009] Another embodiment provides a connector for use with a tissue
shaver. In this embodiment, the connector includes a housing having
proximal and distal ends. The proximal end of the connector can have a
drive feature for coupling to a driver disposed in a handle of the tissue
shaver. Similarly, the distal end of the connector can have a drive
feature for coupling to a corresponding drive feature on a proximal end
of an inner shaft of a tissue shaver. The housing of the connector can
further include a lumen that extends between an entry port formed in the
distal end of the housing for receiving fluid from an inner shaft of a
tissue shaver, and an exit port formed in a sidewall of the housing at a
location distal to the proximal end of the housing for directing fluid
away from a handle of a tissue shaver. The proximal end of the housing
can also include a first mating feature formed thereon and configured to
press-fit with a handle of a tissue shaver, and the distal end of the
housing can include a second mating featured formed thereon and
configured to press-fit with a shaft assembly of a tissue shaver.

BRIEF DESCRIPTION OF THE DRAWINGS

[0010] The invention will be more fully understood from the following
detailed description taken in conjunction with the accompanying drawings,
in which:

[0011] FIG. 1 is a perspective view of one embodiment of a tissue shaver;

[0012] FIG. 2 is a perspective view of a cutting assembly of the tissue
shaver of FIG. 1;

[0013] FIG. 3 is an exploded perspective view of the cutting assembly of
FIG. 2;

[0014]FIG. 4A is a side view of an outer hub of the cutting assembly of
FIG. 2, showing an exit port formed therein;

[0016] FIG. 5A is a perspective view of an inner hub of the cutting
assembly of FIG. 2, showing a mating element configured to mate to the
inner shaft;

[0017] FIG. 5B is a cross-sectional view of the inner hub of FIG. 5A;

[0018]FIG. 5c is an end view of the inner hub of FIGS. 5A and 5B showing
a mating element configured to mate with a hand piece;

[0019] FIG. 6A is a perspective view of the outer hub of FIGS. 4A and 4B
mated to the inner hub of FIGS. 5A-5C;

[0020] FIG. 6B is a cross-sectional view of the hub assembly shown in FIG.
6A;

[0021] FIG. 7A is an exploded perspective view of the inner and outer
shafts of FIG. 3;

[0022] FIG. 7B is a perspective view of the inner and outer shafts of FIG.
7A mated to one another;

[0023] FIG. 8 is a partially-exploded cross-sectional view of the inner
hub of FIGS. 5A-C mated to the inner shaft of FIG. 3;

[0024] FIG. 9 is a cross-sectional view of the outer hub if of FIG. 4A
mated to the outer shaft;

[0025]FIG. 10 is a cross-sectional view of the shaft and hub assembly of
FIG. 2;

[0026]FIG. 11 is a perspective view of another embodiment of a tissue
shaver;

[0027] FIG. 12A is a perspective view of a connector of the tissue shaver
of FIG. 11, showing an exit port formed therein;

[0028] FIG. 12B is a perspective view of the connector of FIG. 12A showing
a mating element configured to mate to a driver disposed in a shaver hand
piece;

[0029]FIG. 12c is another perspective view of the connector of FIGS. 12A
and 12B showing a mating feature that can mate to a shaver hand piece and
a driver mating element;

[0030]FIG. 13 is an exploded view of the connector of FIGS. 12A and 12B;
and

[0031] FIG. 14 is a cross-sectional view of the connector of FIGS. 12A and
12B;

DETAILED DESCRIPTION

[0032] Certain exemplary embodiments will now be described to provide an
overall understanding of the principles of the structure, function,
manufacture, and use of the devices and methods disclosed herein. One or
more examples of these embodiments are illustrated in the accompanying
drawings. Those skilled in the art will understand that the devices and
methods specifically described herein and illustrated in the accompanying
drawings are non-limiting exemplary embodiments and that the scope of the
present invention is defined solely by the claims. The features
illustrated or described in connection with one exemplary embodiment may
be combined with the features of other embodiments. Such modifications
and variations are intended to be included within the scope of the
present invention.

[0033] The present invention generally provides a tissue shaver that is
configured to minimize contact between tissue/bodily fluid and the shaver
hand piece. In general, an arthroscopic shaver is provided for removing
tissue and reshaping a patient's anatomy, and can include a shaft
assembly for cutting tissue and a reusable shaver hand piece. In one
embodiment, the shaft assembly has a hub that connects the shaft assembly
to the hand piece and that has an exit port for removing tissue and/or
fluid from the device. In another embodiment, a connector is provided
that can couple to the shaft assembly. The connector can have an exit
port for removing tissue and/or fluid from the device. In an exemplary
embodiment, the exit ports of the various embodiments disclosed herein
are positioned so as to prevent cut tissue and/or fluid from coming into
contact with the driver and other elements in the hand piece. For
example, the hub and the connector, and thus the exit ports, can be
positioned distal to the shaver hand piece so that fluid and/or tissue
are prevented from flowing into the hand piece, making it easier to
sterilize the hand piece after each use.

[0034] FIG. 1 illustrates one embodiment of a tissue shaver 10. As shown,
the arthroscopic tissue shaver 10 generally includes a hand piece 300 and
a cutting assembly 100. The hand piece 300 can be configured to be
grasped by a user and it can include various drivers and actuators for
controlling the cutting assembly 100. The cutting assembly 100 can be
configured to sever and transport tissue away from a surgical site.

[0035] While the shaver hand piece 300 can have a variety of
configurations, it is preferably configured to facilitate grasping of the
device 10 and to allow operation of the device with one hand. In the
illustrated embodiment, the hand piece 300 is elongate with a generally
cylindrical shape and includes surface features 314 that can provide
friction between a user's hand and the hand piece 300. The hand piece 300
can house a driver (not shown) that can be operably connected to the
cutting assembly 100 such that engagement of the driver causes the
cutting assembly 100 to sever tissue. The driver can include a drive
shaft (not shown) positioned in a central bore of the handle and that can
extend toward a distal end of the hand piece 300 and can mate with a
variety of cutting assemblies known in the art. The driver can further
include a motor operably coupled to the drive shaft such that engagement
of the motor causes the drive shaft to rotate. The hand piece 300 can be
configured to connect to an external power source that can supply power
to the motor, for example via socket 316. The hand piece 300 can further
include an actuator, such as one or more buttons 310, for actuating the
driver. The buttons 310 can provide signals to a processor that controls
the motor and the buttons 310 can have a variety of functions. For
example, each button 310 can cause the motor to operate in a different
mode, such as a forward mode, reverse mode, or an oscillating mode, or
the buttons 310 can have multiple functions depending upon the speed in
which a user presses them. The hand piece can also include an actuator,
e.g. a rotatable handle 312, for engaging a valve (not shown) that
controls the application of suction to the cutting assembly, or
alternatively, suction can be applied and controlled using a separate
device. The hand piece 300 can also integrate with a fluid management
system, such as the FMS Duo®+ of DePuy Mitek, Inc. In certain
aspects, the hand piece 300 can be configured to be autoclaved without
damaging the functionality of the motor so that the hand piece 300 can be
sterilized after each use. A person skilled in the art will appreciate
that hand piece can have a variety of configurations and various hand
piece assemblies known in the art can be used with the present invention.

[0036] FIGS. 2 and 3 show the cutting assembly 100 of the arthroscopic
shaver of FIG. 1 in more detail. As explained above, the cutting assembly
100 is configured to cut and remove tissue from a surgical site. In the
illustrated embodiment, the cutting assembly 100 generally includes outer
and inner shafts 110, 112 and a hub assembly 130. The outer shaft 110 can
be mated to an outer cutting element 124 and similarly, the inner shaft
112 can be mated to an inner cutting element 122. The inner shaft 112 can
be configured to rotate relative to the outer shaft 110 to thereby cut
tissue. As shown, the hub assembly 130 can mate the shafts 110, 112 to
the shaver hand piece 300 and can include an exit port 136 for receiving
tissue and/or fluid from the shafts 110, 112. A person skilled in the art
will appreciate that the cutting assembly can include different
components and can have a variety of other configurations for cutting and
receiving tissue.

[0037] The hub assembly 130 can have various configurations, but in one
embodiment, as shown, the hub assembly 130 includes an outer hub 132 and
an inner hub 134. FIGS. 4A-4B show the outer hub 132 in more detail.
While the shape of the outer hub 132 can vary, the illustrated hub has a
generally frustoconical shape at a distal end 132b with a
reduced-diameter cylindrical portion at a proximal end 132a. The distal
end of the outer hub 132 can be configured to fixedly and non-rotatably
mate to the outer shaft 110. Various mating techniques can be used, as
will be discussed in more detail below with respect to the outer shaft
110. The proximal end of the outer hub 132 can be configured to mate to
the hand piece 300. Various mating techniques known in the art can be
used, such as welding, adhesives, a mechanical engagement, etc. The outer
hub 132 also has a lumen 138 that extends along a central axis L between
the proximal and distal ends 132a, 132b for transporting tissue and fluid
from a surgical site. An exit port 136 can extend between the lumen 138
and an outer sidewall of the outer hub 132. The angle of the exit port
136 relative to the central axis L can vary, e.g. the exit port can
extend perpendicular to the axis L, or it can extend at an acute or
obtuse angle, as shown. A person skilled in the art will appreciate that
the exit port 136 can have a variety of other configurations. The hub
assembly can also be formed from a variety of different materials,
including by way of non-limiting example, surgical grade stainless steel,
titanium, and plastics.

[0038] As explained, the hub assembly 130 can also include an inner hub
134 that can mate to the inner shaft 112 and can rotatably couple to the
outer hub 132. FIGS. 5A-5C show different views of the inner hub 134 of
FIG. 2. While the inner hub 134 can have a variety of configurations, in
the illustrated embodiment the inner hub 134 is a generally cylindrical
member having a proximal end 134a and a distal end 134b. The inner hub
134 can have a larger diameter portion on its proximal end 134a and a
smaller diameter cylindrical portion on its distal end 134b so that its
proximal end 134a can mate to the shaver hand piece 300 and its distal
end 134b can seat in a portion of the outer hub 132. The smaller diameter
portion can taper distally and can terminate at a pointed distal tip 144.
The distal end 134b of the inner hub 134 can have a mating feature 142
for mating with the inner shaft 112. While various mating features can be
used, in one embodiment the mating feature can be in the form of a
circular slot that extends from the distal end 134b of the hub 134 to an
interior portion of the hub 134, as shown in FIGS. 5A-5B. This mating
feature 142 can be configured to receive a proximal end 112a of the inner
shaft 112, as will be described in more detail. As shown in FIG. 5c, the
proximal end 134a of the inner hub 134 can include a driver mating
feature 148 for mating with a driver disposed in the shaver hand piece
300 such that engagement of the driver causes rotation of the inner hub
134. In the illustrated embodiment, the driver mating feature 148 is in
the form of a rectangular socket, however any form of mating feature
known in the art can be used.

[0039] The inner and outer hubs 134, 132 can be mated, as shown in FIGS.
6A and 6B. In the illustrated embodiment, the distal end 134b of the
inner hub 134 is inserted into the lumen 138 in the proximal end 132a of
the outer hub 132, and it can be secured by a press-fit. A person skilled
in the art will appreciate that the inner hub 134 can be secured to the
outer hub 132 in a variety of other ways. In a preferred embodiment, the
exit port 136 is unobstructed by other components, such as inner hub 134,
so that tissue and/or fluid can flow through the exit port 136. For
example, in the illustrated embodiment the distal end 134b of the inner
hub 134 has a pointed distal tip 144 that terminates proximal to the exit
port 136 so that tissue and fluid can readily flow through the exit port
136 and out of the device.

[0040] The cutting assembly 100, and in particular the inner and outer
shafts 112, 110 for cutting and transferring tissue and/or fluid from a
surgical site, can also have a variety of configurations. FIGS. 7A and 7B
show the shafts in greater detail. In general, the inner and outer shafts
112, 110 are elongate members having proximal ends 112a, 110a, distal
ends 112b, 110b, and inner lumen 117a, 117b extending therethrough. Both
shafts can include features, such as a plurality of friction elements
116, configured to fixedly secure the shaft within the hub assembly 130
using a press-fit. Various other mating techniques known in the art can
be used to secure the shafts 110, 112 within the hub assembly 130, such
as welding, adhesives, a mechanical engagement, or any other technique.
The inner shaft 112 can be configured to rigidly and non-rotatably mate
to the inner hub 134 and can optionally be integrally formed as a single
component such that the inner shaft 112 and the inner hub 134 are
configured to move together as a unit. Similarly, the outer shaft 110 can
be configured to rigidly and non-rotatably mate to the outer hub 132 and
can be integrally formed as a single component. In the illustrated
embodiment, the inner shaft 112 has a length that is greater than a
length of the outer shaft 110, and the inner shaft 112 has an outer
diameter that is less than an inner diameter of the outer shaft 110 so
that it can rotate within the outer shaft. The inner shaft 112 can
further include ports 118 for transferring tissue and fluid from the
inner shaft 112 to the exit port 136 disposed in the outer hub 132. The
ports 118 are preferably positioned at a location proximal to the
proximal end 110a of the outer shaft 110, when the device is assembled,
so that the outer shaft 110 does not block fluid flow through the ports
118.

[0041] As further shown, the distal ends 112b, 110b of the inner and outer
shafts 112, 110 can also be configured to mate with an inner cutting
member 122 and an outer cutting member 124, respectively. While the
cutting members 122, 124 can have a variety of configurations, they are
preferably configured to excise adjacent tissue from a surgical site. In
the illustrated embodiment, the cutting members 122, 124 have a
substantially cylindrical shape and include elliptical shaped openings
126, 128 that extend through an outer sidewall. The openings 126, 128 can
have serrated teeth 129a, 129b on their circumference for cutting tissue.

[0042] The components of the arthroscopic shaver of FIG. 1 can be
assembled during the manufacturing process or by a user. For example, the
inner shaft 112 can be mated with the inner hub 134 and the outer shaft
110 can be mated with the outer hub 132, as shown in FIGS. 8 and 9,
respectively. The distal end 112b of the inner shaft 112 can be inserted
into the proximal end 132a of the outer hub 132 and through the outer
shaft 110 until the components are secured by a press-fit, as illustrated
in FIG. 10. In the alternative, the shafts 110, 112 and hubs 132, 134 can
be integrally formed during the manufacturing process. In both
embodiments, the outer and inner hubs 132, 134 can be mated to the distal
end 300a of the shaver hand piece 300 by a press-fit or using other
mating techniques, e.g. using threads, or other mechanical techniques. In
addition, the driver mating feature 148 on the proximal end 132a of the
inner hub 134 can mate to a driver disposed in the shaver hand piece 300
so that engagement of the driver causes rotation of the inner hub 134. In
particular, a shaft of the driver can be keyed to extend into and engage
the mating feature 148 so that the driver can thereby effect rotation of
the inner hub 134 and inner shaft 112. After a procedure is complete, the
cutting assembly 100 can be disengaged from the hand piece 300 and
disposed of, while the hand piece 300 can be cleaned and reused. A person
skilled in the art will appreciate that the components of the tissue
shaver can be assembled in numerous ways and using a variety of securing
mechanisms.

[0043] In use, the cutting assembly 100 of the tissue shaver 20 can be
inserted into an incision made in a patient. Optionally, the depth of the
cutting assembly 100 within the incision can be monitored using
fluoroscopy, X-ray, or other visualization techniques known in the art.
After the cutting assembly 100 is positioned at the desired depth,
suction can be applied through exit port 136. Tissue adjacent to the
outer cutting member 124 is drawn through the openings 128, 126,
respectively. The actuators 310 on the shaver hand piece 300 can be
depressed or otherwise activated, which causes the inner shaft 112 to
rotate relative to the outer shaft 100. Because the shafts are
non-rotatably coupled to the cutting members 122, 124, inner cutting
member 122 rotates relative to the outer cutting member 110 and the
tissue trapped in the inner cutting member 122 is cut by the serrated
teeth 129a, 129b. The applied suction causes the cut tissue and/or fluid
to flow through the lumen 117b in the inner shaft 112 and out through
exit port 136 formed in the outer hub 132. The cut tissue and/or fluid
can be collected in a suitable waste collection container. This process
can be repeated until the desired amount of tissue is excised from the
surgical site. After the procedure is complete, the cutting assembly 100
can be disengaged from the hand piece 300 and disposed of, while the hand
piece 300 can be cleaned and reused.

[0044] Components are also provided for retrofitting existing shaver hand
pieces that have an inner lumen for removing fluid and tissue from the
device. For example, in one embodiment a tube can be inserted in the
inner lumen of a hand piece and can extend between proximal and distal
ends of the hand piece. A distal end of the tube can be mated with a
proximal end of the cutting assembly, such as a proximal end of an inner
shaft, and a proximal end of the tube can be coupled to a waste
collection container. Preferably, the cutting assembly and the tube have
a fluid-tight connection that prevents tissue and fluid from directly
contacting the inner lumen of the hand piece. As shown in FIG. 11, in
another embodiment a tissue shaver 20 can include a cutting assembly (not
shown), a connector 200, and a hand piece 400. The connector 200 can
connect a cutting assembly to the hand piece 400 and can prevent tissue
and fluid from entering the exit port in the shaver hand piece 400. More
specifically, one end of the connector 200 can mate to a cutting assembly
and the other end can mate to a hand piece 400. The connector 200 can
divert tissue and/or fluid away from the shaver hand piece 400 and
thereby minimize contact between the biological material and the shaver
hand piece 400. In both of the embodiments, tissue and bodily fluid is
prevented from directly contacting a shaver hand piece, making cleaning
and sterilization of the hand piece simpler and more effective.

[0045] FIGS. 12A-12C illustrate the connector 200 of FIG. 11 in greater
detail. The connector 200 can mate to a cutting assembly and to a shaver
hand piece 400, and can divert tissue away from the hand piece 400. In
the illustrated embodiment, the connector 200 is a substantially
cylindrical component that includes tubular-shaped outer and inner hubs
232, 234. The outer and inner hubs 232, 234 operably connect the cutting
assembly to the shaver hand piece 400 and prevent tissue from contacting
the shaver hand piece 400. The outer hub 232 further includes an exit
port 236 for diverting tissue from entering the hand piece 400. As shown
in FIG. 12A, the outer hub 232 has a lumen 244 that extends between the
proximal and distal ends 232a, 232b. The exit port 236 extends between
the lumen 244 and an outer sidewall of the outer hub 232. The inner hub
234 blocks the proximal end of the lumen in the outer hub 232, such that
fluid is forced to flow through the exit port 236 and is prevented from
flowing into the hand piece (not shown). The position of the exit port
236 can vary, but it is preferably located distal to the proximal end
232a of the outer hub 232, and distal to the distal end 234b of the inner
hub 234 when the hubs are assembled so that the inner hub 234 does not
obstruct the exit port 236. A person skilled in the art will appreciate
that the outer and inner hubs can be formed from a variety of different
materials and can have a variety of configurations.

[0046] Because the connector 200 is an intermediary component positioned
between the shaver hand piece 400 and the cutting assembly, the driver
disposed in the shaver hand piece 400 will not directly mate with the
cutting assembly. Instead, the outer and inner hubs 232, 234 are
configured to transfer a drive force between the hand piece 400 and the
cutting assembly such that actuation of the driver disposed in the hand
piece 400 causes the cutting assembly to sever tissue. As shown in FIGS.
12B and 12C, the inner hub 232 can include a driver mating feature 248 at
a proximal end for mating to a driver disposed in the shaver hand piece
400. The inner hub 234 can further include a protrusion 240, shown in
FIG. 13, at a distal end 234b for mating directly to a portion of a
cutting assembly, such as a shaft. Alternatively, an intermediate
component (not shown) can join the inner hub 234 to the cutting assembly
such that rotation of the inner hub 234 causes rotation of the cutting
assembly. FIGS. 12A-14 also show the outer hub 232, which has two mating
features 242 that can mate to corresponding features on the shaver hand
piece 400. In the illustrated embodiment, the hand piece 400 can be
guided toward the proximal end 230a of the hub 230, and a distal portion
of the hand piece 400 can seat in slot 247a. The hand piece 400 can
further include protrusions that correspond to mating features 242 so
that the hand piece 400 can be twist-locked and secured to the connector
200. FIG. 13 is an exploded view of the connector 200 that shows the
components in more detail. A person skilled in the art will appreciate
that the connector can have a variety of configurations and can include a
variety of mating features configured to join the connector with a
cutting assembly and a shaver hand piece.

[0047] As shown in FIG. 14, the outer hub 232 can include mating elements
238 on its distal end 232b for mating to a cutting assembly. In the
illustrated embodiment, the mating elements 238 are substantially
L-shaped depressions formed in an inner sidewall of the outer hub 232.
Corresponding protrusions on the cutting assembly can engage the mating
elements 238 and the cutting assembly can be secured to the outer hub 232
using a twist-lock. A portion of the cutting assembly can also be seated
in slot 247b formed in the outer hub 232 to allow rotation of the cutting
assembly relative to the outer hub 232, and thus the connector 200, as
will be discussed below. A person skilled in the art will appreciate that
the cutting assembly can be secured to the connector by various other
means known in the art.

[0048] FIG. 14 also shows a cross-section of the inner hub 234 mated to
the outer hub 232 by a press-fit. The inner hub 234 can be mated to the
outer hub 232 by various other mating techniques known in the art, such
as welding, adhesives, a mechanical engagement. In the illustrated
embodiment, the inner hub 234 is positioned so that the exit port 236 is
unobstructed by the inner hub 234. Preferably, when the cutting assembly
is attached to the outer hub 232 there is space in the inner lumen 244 of
the outer hub 232 for tissue and/or fluid to flow through the inner lumen
244 and out through the exit port 236. In addition, the protrusion 240 of
the inner hub 234 preferably terminates at a location proximal to the
exit port 236 to allow tissue and fluid to readily flow through the exit
port 236. A person skilled in the art will appreciate that the angle of
the exit port 236 relative to the lumen 244 can vary, e.g. the exit port
236 can extend perpendicular to the lumen 244 or it can extend at an
acute or obtuse angle.

[0049] The arthroscopic shaver of FIG. 11 functions similar to the
embodiment shown in FIG. 1. In use, the cutting assembly (not shown) of
the tissue shaver 20 can be inserted into an incision made in a patient.
The position of the cutting assembly can be monitored using a variety of
visualization techniques known in the art, such as X-ray imaging. Suction
can be applied to the cutting assembly at exit port 236 disposed in the
connector 200. The applied suction draws tissue adjacent to the cutting
members through their respective openings and into an inner lumen. The
actuators 410 on the shaver hand piece 400 can be depressed, causing the
cutting assembly to sever the tissue disposed in the inner lumen of the
cutting assembly, such as by the rotation of inner and outer cutting
elements. Actuation of the driver causes the inner hub 234 to rotate
relative to the outer hub 232. Because the inner hub 234 has a protrusion
240 that is operably coupled to the inner shaft of the cutting assembly,
rotation of the inner hub 234 causes the inner shaft to rotate relative
to the outer hub and an outer shaft, thereby severing tissue. The cut
tissue and/or fluid to flows through the lumen of the cutting assembly
and out through the exit port 236 formed in the outer hub 232 of the
connector 200. Rather than allowing tissue and/or fluid to flow through
an inner lumen in the shaver hand piece 400, the connector 200 diverts
this material away from the shaver hand piece 400 and out through exit
port 236. Because tissue and fluid is prevented from entering the hand
piece 400, the hand piece 400 is easier to clean and has a decreased risk
of cross-contaminating a surgical site. The cut tissue and/or fluid can
be collected in a suitable waste collection container and the process can
be repeated until the desired amount of tissue is excised from the
surgical site. Similar to the embodiment shown in FIG. 1, after the
procedure is complete, the cutting assembly can be removed from the
connector 200 and disposed of, and the connector 200 can be removed from
the shaver hand piece 400. The shaver hand piece 400 and/or the connector
200 can be cleaned and reused, if desired.

[0050] As will be appreciated by a person skilled in the art, the tissue
shavers provided can be used to remove tissue from various regions in the
body, including by way of non-limiting example, shoulder, hip, wrist,
knee, and spine.

[0051] One skilled in the art will appreciate further features and
advantages of the invention based on the above-described embodiments.
Accordingly, the invention is not to be limited by what has been
particularly shown and described, except as indicated by the appended
claims. All publications and references cited herein are expressly
incorporated herein by reference in their entirety.

Patent applications by Robert C. Thistle, Bridgewater, MA US

Patent applications by DEPUY MITEK, INC.

Patent applications in class Cutter carried on elongated probe-like member

Patent applications in all subclasses Cutter carried on elongated probe-like member